Provider Demographics
NPI:1720137409
Name:PALISADES REHABILITATION SERVICES, INC.
Entity Type:Organization
Organization Name:PALISADES REHABILITATION SERVICES, INC.
Other - Org Name:PALISADES REHABILITATION CENTER OF CRESSKILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:MUELLER
Authorized Official - Last Name:LONGEST
Authorized Official - Suffix:
Authorized Official - Credentials:OTR L
Authorized Official - Phone:201-541-9222
Mailing Address - Street 1:220 KNICKERBOCKER RD
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-1827
Mailing Address - Country:US
Mailing Address - Phone:201-541-9222
Mailing Address - Fax:201-541-1711
Practice Address - Street 1:220 KNICKERBOCKER RD
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626-1827
Practice Address - Country:US
Practice Address - Phone:201-541-9222
Practice Address - Fax:201-541-1711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ316671Medicare Oscar/Certification